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NPI Code Detail

MEDICARE: MRS. KRISTIN DANIELLE FISHER P.A.

MEDICARE: MRS. KRISTIN DANIELLE FISHER P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363A00000XPhysician AssistantP49983NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134165665
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTIN DANIELLE FISHER P.A.
Provider Business Mailing Address
First Line : PO BOX 92249
Second Line :
City : ROCHESTER
State : NY
Zip : 14692-0249
Country : US
Telephone Number : 716-834-1193
Fax Number : 716-348-3925
Provider Business Practice Location Address
First Line : 445 TREMONT STREET
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-6150
Country : US
Telephone Number : 716-690-2303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 03/16/2026

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